Individual
MR. FAY ALLEN GOODALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
185 W 4TH AVE, STE C, POST FALLS, ID 83854-4979
(208) 457-8746
(208) 457-8767
Mailing address
PO BOX 2316, POST FALL, ID 83877
(208) 457-8746
(208) 457-8767
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT 10062
CA
225100000X
Physical Therapist
Primary
PT-286
ID
225100000X
Physical Therapist
PT00002838
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010019002
REGENCE BLUE SHIELD
ID
05
—
002609200
—
ID
01
—
2937
WASHINGTON LABOR & INDUST
WA
01
—
4004
STATE INSURANCE FUND
ID
01
—
82040818683854A003
TRICARE
—
01
—
T-5345
BLUE CROSS
ID
Enumeration date
05/01/2007
Last updated
04/26/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us